Question

Managing a Patient with a hip fracture

An 87 year old female is admitted to the hospital with a diagnosis of a hip fracture secondary to a fall in her home.

What clinical manifestations would you expect to see when assessing this patient?

1. What would be three nursing management considerations for this patient pre-operatively?  
2. What would be three nursing management considerations post-surgical repair?  
3. What would your peripheral neurovascular assessment of the lower extremity include?  
4. Are there any positioning considerations, if so what are they?

References pls

Answer 1

Answer: Along with the age the bone starts to lose calcium and hence makes bone weak. Mainly the older people are higher at risk of hip fracture because bones tend to weaken with age that is also called (osteoporosis). Sometimes the major issue related to fall of elderly people are a poor vision and balance problems which may result in cases of hip fracture. For the assessment physician do X-Ray to know about the intensity of the fracture. If X-Ray did not provide enough information then there is need of MRI.

The nursing management consideration for hip fracture pre-operatively are:

• Antibiotics such as cephalosporin should be given prior to surgery and should be stopped within 24 hours.
• Nutritional supplement should be provided as in this case the lady is old enough and there is a lack of calcium.
• Pain management should be done but with the limited use of narcotics.

Nursing management considerations post-surgical repair:

• The Femoral neck fractures surgery is typical and most difficult to heal.
• There is an acute loss of blood so the blood level should be maintained.
• Medicines should be given properly and movement should be avoided.

The peripheral neurovascular assessment of the lower extremity should include the pain, severity and the movement and also the sensation. The patient should be kept under observation after the surgery at least 2 hours to assess the pain and sensation.